Individual provider Active NPI

Nectarios Chris Bonatsakis, LCSW

  • Clinical Social Worker
  • Farmington, CT
National Provider Identifier
1023472974
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
010449 Issued in CT
Practice address
263 Farmington Ave
Farmington, CT 06030-0001
Phone
(860) 679-6700
NPI assigned
Apr 7, 2016
Last updated
Feb 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 010449 CT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

263 Farmington Ave
Farmington, CT 06030-0001

Mailing address

263 Farmington Ave
Farmington, CT 06030-8082
Phone (860) 679-4165

Other practice location 1

34 Jerome Ave Ste 116
Bloomfield, CT 06002-2463
Phone (860) 597-8041

Other practice location 2

153 Hazard Ave
Enfield, CT 06082-4592
Phone (860) 253-5020

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nbonatsakis59092@direct.med.uchc.edu
Direct Messaging Address nbonatsakis59092@direct.med.uchc.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221201001619 CT Practitioner - Clinical Social Worker 7911375548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Connecticut School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010449CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Aug 20, 2022 Accepting new patients
State of Connecticut Clinical CurrentSince Aug 20, 2022 Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

Interoperability endpoints

  • Direct secure messaging: nbonatsakis59092@direct.med.uchc.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1023472974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060308082",
            "telephone_number": "860-679-4165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Jerome Ave Ste 116",
            "address_purpose": "LOCATION",
            "city": "Bloomfield",
            "state": "CT",
            "postal_code": "060022463",
            "country_code": "US",
            "telephone_number": "860-597-8041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "153 Hazard Ave",
            "address_purpose": "LOCATION",
            "city": "Enfield",
            "state": "CT",
            "postal_code": "060824592",
            "country_code": "US",
            "telephone_number": "860-253-5020",
            "fax_number": "860-253-5030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONATSAKIS",
        "first_name": "NECTARIOS",
        "middle_name": "CHRIS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-07",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "010449",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nbonatsakis59092@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "Uconn Medical Group",
            "address_2": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nbonatsakis59092@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "263 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.